CLAIM FOR COMPENSATION FOR LINE OF DUTY COMPENSATION BENEFITS (death occurred on or after August 28, 2017 and before August 28, 2018) Forms
| Form Name | CLAIM FOR COMPENSATION FOR LINE OF DUTY COMPENSATION BENEFITS (death occurred on or after August 28, 2017 and before August 28, 2018) |
| Form # | WCLoD-1B |
| Form Revision | (01-23) |
| Category | Forms » Financial/Compensation |
| Downloads | |
| Form State | Missouri |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |